(24-01-13) Risk of ischaemic heart disease in patients with inflammatory bowel disease: a nationwide Danish cohort study.

Rungoe C, Basit S, Ranthe MF, Wohlfahrt J, Langholz E, Jess T.
Source
Statens Serum Institut, National Institute for Health Data and Disease
Control, Copenhagen, Denmark.
Abstract
BACKGROUND:
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Systemic
inflammation increases the risk of atherosclerosis and ischaemic heart disease
(IHD).
OBJECTIVE:
To examine the impact of IBD, including its duration and treatment, on the
risk of IHD.
METHODS:
In a nationwide population-based cohort of 4.6 million Danes aged ??15 years,
we compared people diagnosed with IBD during 1997-2009 (n=28 833) with IBD-free
individuals. Subjects with IHD were identified in the National Patient
Register. Using Poisson regression, we estimated the incidence rate ratios
(IRRs) for IHD with 95% CI with adjustment for age, gender, socioeconomic
status, calendar year and use of drugs for comorbidities.
RESULTS:
A markedly increased risk of IHD was seen within the first year after IBD
diagnosis (IRR=2.13 95% CI 1.91 to 2.38). During 1-13 years of follow-up after
IBD diagnosis, the risk of IHD was 1.22 (95% CI 1.14 to 1.30). The risk of IHD
was lower among patients with IBD using 5-aminosalicylic acids (IRR=1.16; 95%
CI 1.06 to 1.26) than among non-users (IRR=1.36; 95% CI 1.22 to 1.51) (p=0.02),
in particular among oral corticosteroid users, used as a proxy for disease
severity. Likewise patients treated surgically or with thiopurines and tumour
necrosis factor ?? antagonists tended to have reduced IRRs for IHD.
CONCLUSIONS:
The risk of IHD was highest in the first year after IBD diagnosis, possibly
owing to ascertainment bias. The increased long-term risk of IHD in IBD may be
related to chronic inflammation, and interventions reducing the inflammatory
burden may attenuate this risk.

Source: Gut. 2012 Sep 26. [Epub ahead of print]

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